Across the U.S. each year millions of back pain sufferers are treated with steroid shots in the hope it will ease pain and inflammation.

Tom Presby, of Fairhaven, has received a long list of treatments during his eight year battle with back pain, including shots, medications, physical therapy and pain patches. Severe back pain has left Presby unable to work.

He’s not alone. A recent review of Medicare records showed a 629 percent increase in the number of shots given for back pain, even though there has been no documented corresponding improvement in patient outcomes.

And that’s the problem, said famed New York University bioethicist Art Caplan, Ph.D. "The studies do not support this huge use of shots for back pain," he said. “In fact, there isn’t a lot of evidence that these shots do a lot of good.”

Caplan points to a British Medical Journal study showing steroid injections for back pain were no more effective than a saline placebo.

And a recent review of a dozen studies published in the Annals of Internal Medicine determined the shots had no long or short-term effect on pain caused by sciatica.

"It's an important tool to get the acute pain under control," said Dr. Zacharia Isaac, the medical director of the spine center at Boston’s Brigham and Women’s Hospital.

Isaacs hears the concern, and agrees steroid injections do not work well for pain that stays in the lower back.

However, he said that when pain radiates down a person’s leg, or is caused by stenosis or a herniated disc, steroid shots can be a useful treatment for carefully selected patients when all else has failed.

Caplan said, "I think they do help a few people but there overused many, many times over.”

Both Caplan and Isaac call the NECC scandal a tragedy. Isaac said patients are concerned, but often feel more at ease when he reassures them that Brigham and Women’s Hospital has not bought any steroids from NECC.